胃、结直肠癌肝转移的介入治疗(附55例报告)

The interventional chemotherapy em bolization for liver metastases fro m gastric and colorectal cancer.

目的评价胃、结直肠癌肝转移瘤介入治疗效果及影响因素。方法采用Seldinger法经股动脉插管,治疗胃癌、结直肠癌肝转移21例、34例。化疗药物选择5-Fu、PDD、ADM或ADM与碘化油乳剂作栓塞治疗。结果1胃、结直肠癌肝转移瘤总有效率CR+PR为64%;234例转移瘤碘化油沉积CT分为四型:均匀型占20%,非均匀型占39%,环型占9%,无碘油沉积型占32%;3转移瘤疗效最好者为单发、多血供病灶及均匀碘化油蓄积者;464%病例治疗后出现肝外转移。结论介入化疗栓塞治疗为胃、结直肠癌肝转移有效的姑息治疗手段。

Objective To evaluate chemoembolization in tr eating liver metastases of gastric a nd colorectal carcinoma,and study i ts effective factors.Methods Percutaneous selective hepatic arterial infusion chemotherapy(5-Fu、PDD、ADM)and embolization(mixture of iodic oil and ADM)was performed in 55patients with liv er metastases from gastric and colorectal carcinoma.Results1.CR +PR was 64%in the study group.2.the accumulation pattern of lipiodol in the liver tu mors was assessed on CT in 34patients.It was classified into four groups:A)homogeneous pattern(20%);B)heterogeneous pattern(39%);C)accumulation with a central defect(9%)and D)no accumula-tion(32%).3.The best effect was seen in cases with the hypervascular and the single metastatic focus,and seen in lesion s with the ho-mogeneous accumulation of lipiodol .4.64%patients was showed the extra hepatic metastatic lesions after th e interventional chemoem-bolization.Conclusions The interventional chemoembolization is an effective palliative treatment of liver metastases from gastric and col-orectal carcinoma.[